Abstract

Transcranial Magnetic Stimulation (TMS) can be used to map cortical motor topography by spatially sampling the sensorimotor cortex while recording Motor Evoked Potentials (MEP) with surface electromyography (EMG). Traditional sampling strategies are time-consuming and inefficient, as they ignore the fact that responsive sites are typically sparse and highly spatially correlated. An alternative approach, commonly employed when TMS mapping is used for presurgical planning, is to leverage the expertise of the coil operator to use MEPs elicited by previous stimuli as feedback to decide which loci to stimulate next. In this paper, we propose to automatically infer optimal future stimulus loci using active learning Gaussian Process-based sampling in place of user expertise. We first compare the user-guided (USRG) method to the traditional grid selection method and randomized sampling to verify that the USRG approach has superior performance. We then compare several novel active Gaussian Process (GP) strategies with the USRG approach. Experimental results using real data show that, as expected, the USRG method is superior to the grid and random approach in both time efficiency and MEP map accuracy. We also found that an active warped GP entropy and a GP random-based strategy performed equally as well as, or even better than, the USRG method. These methods were completely automatic, and succeeded in efficiently sampling the regions in which the MEP response variations are largely confined. This work provides the foundation for highly efficient, fully automatized TMS mapping, especially when considered in the context of advances in robotic coil operation.

Highlights

  • T MS has become a valuable noninvasive method to map the motor cortical representation of a specific muscle [1].The basic procedure is to apply Transcranial Magnetic Stimulation (TMS) pulses to a variety of locations on the scalp overlying the sensorimotor cortex while recording EMGs from target muscle(s), and quantifying the amplitude of resultant Motor Evoked Potentials (MEP)

  • This is the case for TMS mapping where measured MEP amplitudes are inherently non-negative quantities. To circumvent this issue for our setting, a mapping function can be applied to Gaussian random variables to enforce nonnegativity, resulting in non-Gaussian random variables. These procedures with non-linear mappings are known as Warped Gaussian Process (GP) (WGPs) [25], [32], which we describe in detail

  • Lower Group Mean (GM) normalized mean squared error (NMSE) was observed for USRG and RAND when compared with the GRID approach (GM NMSE: 0.36±0.11, 0.68±0.17, 0.99±0.00 respectively) after 49 simulations

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Summary

Introduction

T MS has become a valuable noninvasive method to map the motor cortical representation of a specific muscle [1].The basic procedure is to apply TMS pulses to a variety of locations on the scalp overlying the sensorimotor cortex while recording EMGs from target muscle(s), and quantifying the amplitude of resultant MEPs. The current standard technique for mapping involves stimulating with the TMS coil 3-10 times at each site on a regular grid, most commonly consisting of 25100 points at a 0.5-1 cm spacing. These points are typically identified on the scalp by physically drawing on a swimmer’s cap or using computer-guided navigation systems [5], [6]. Much of this time is spent recording null responses, since the majority of the stimulation points typically lie outside of the excitable area for the muscle of interest [7] This time scale prohibits measurement of transient cortical stimulation or learning-induced changes and is not well tolerated by clinical populations. A pseudo-random walk sampling pattern combined with interpolation of excitability among the stimulation sites was reported to produce statistically similar outcomes to gridbased approaches with comparatively fewer stimuli [9]–[11]

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